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Published on: April 2, 2012
Neonatal Herpes Simplex Virus Disease: Updates and Continued Challenges
Nicole L Samies1, Scott H James1, David W Kimberlin1
1Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Alabama at Birmingham, Children's Harbor Building 308, 1600 7th Avenue South, Birmingham, AL 35233-1711, USA.
Insights
Neonatal herpes simplex virus (HSV) disease management has improved significantly with acyclovir and PCR detection. However, high infant morbidity and mortality necessitate ongoing research, particularly in vaccine development and rapid diagnostics.
Area of Science:
- Neonatal infectious diseases
- Virology
- Maternal-fetal medicine
Background:
- Neonatal herpes simplex virus (HSV) disease poses a significant threat to infant health.
- Historically, outcomes for affected neonates were poor, with high rates of mortality and long-term neurological sequelae.
- Recent decades have seen substantial progress in understanding and managing this condition.
Purpose of the Study:
- To define neonatal HSV disease.
- To review the evolution of its management over the past 40 years.
- To highlight areas for future improvement in neonatal HSV care.
Main Methods:
- Literature review of advancements in neonatal HSV management.
- Analysis of the impact of antiviral therapy (acyclovir) and diagnostic techniques (PCR).
- Examination of clinical guidelines for managing infants born to mothers with genital HSV lesions.
Main Results:
- Introduction of acyclovir in the 1980s revolutionized treatment efficacy.
- Development of polymerase chain reaction (PCR) in the 1990s enabled faster and more accurate HSV DNA detection.
- Established protocols for managing infants exposed to maternal HSV have improved outcomes, yet challenges remain.
Conclusions:
- Despite significant advancements, neonatal HSV disease continues to be associated with considerable morbidity and mortality.
- Continued research is crucial, focusing on novel therapeutic strategies and improved diagnostic tools.
- Future efforts should prioritize the development of effective HSV vaccines and rapid, point-of-care PCR detection methods for use during delivery.
Abstract:
This article defines neonatal herpes simplex virus (HSV) disease and describes the progress over the past 40 years that has revolutionized the management of HSV disease in neonates to improve their outcomes. These advancements include the introduction of acyclovir in the 1980s, polymerase chain reaction (PCR) for the detection of HSV DNA in the 1990s, and recommendations on managing infants born to mothers with active genital lesions. Despite these advancements, however, there remain high morbidity and mortality in affected neonates, with need for continued improvement. Areas of high interest include vaccine development and rapid PCR detection at time of delivery.
